Maternity Information Leaflet Recovery following your Caesarean Section
This leaflet provides information to help you recover following a Caesarean Section (CS) birth. Recovery after a CS may take a little longer and you may need extra assistance in the first few days and weeks with your own and your baby s care. Some women may feel upset or disappointed following their CS, especially if the CS was unplanned. It is important to talk about how you feel and you can talk to the midwife or doctor to find out more about what happened and why. It might also be useful to talk about how your CS may affect any future pregnancy. If you are not ready to talk or ask questions before you leave hospital you can also contact the Midwife Counsellor/Birth Afterthoughts Midwife at a later date on 07876 475772. While you are in hospital Most women stay in hospital for around 3-4 days following a CS birth, but some may feel well enough to go home after 24 hours. Please talk to the doctors and midwives to decide the right time for you to go home. Early mobilization following CS birth is recommended as this will support your recovery. IV drip and urinary catheter most women will have these following a CS birth. The IV drip will usually be removed once you are able to eat and drink normally. The urinary catheter (a tube into the bladder connected to a bag to keep the bladder empty) is usually removed between 12 and 24 hours after your CS, when you are able to walk to the toilet. Pain relief pain relief medication will be prescribed for you after a CS birth and it is important to take this at regular intervals so that you are comfortable and able to move around. If you need extra pain relief please ask as additional medication can be given in between your prescribed doses to help make you comfortable. 2
Showering you can get up and shower quite soon after your CS, from around 12 24 hrs onwards depending on how you feel. The wound dressing is usually waterproof so this does not need to be removed before your shower. Wound care & stitches It is very important to make sure that your wound stays as clean and dry as possible. The dressing is usually removed 24-48 hours after your CS and the stiches usually dissolve and do not need to be removed. Shower daily and pat the wound dry with a clean non fluffy towel once the dressing is removed. Wearing loose comfortable clothing and cotton underwear also helps. Getting back to normal early days During pregnancy your body undergoes a lot of changes to accommodate the growing baby and therefore regaining your pre pregnancy shape can take some time (up to a year after the birth). You may find that, because your tummy muscles have been stretched, they are weaker than before and although this is quite normal it can make moving around and getting in and out of bed more challenging. In addition, because your abdominal muscles also help support your back, while they are still weak it is important to take care of your back. Here are some suggestions for things that may help. To get out of bed, roll on your side and bring your knees up towards your chest, then use your arms to help push yourself up into a sitting position. You can do this in reverse when getting 3
To stand up from sitting move forward to the edge of the chair or seat and tuck your legs under you so that you can use your legs to help you get up. When walking, try to avoid walking in a stooped posture standing tall from the start. This will not harm your wound and helps protect your back. When you are coughing or sneezing, support your wound by holding firmly with your hand flat over your wound/abdomen. Early Exercises Deep breathing and leg exercises You can start these right after your CS to help reduce your risk of chest infection and deep vein thrombosis (clots in the veins). Breathing take a deep breath in through your nose so that your stomach rises and breathe out slowly to count of five. Repeat this for five breaths several times a day. Leg exercises circle your foot around first one way and then the other, point your toes down and then lift your toes up towards you again and repeat several times. As you may feel sore or uncomfortable after your CS make sure you have regular pain relief so that you can do these exercises and it will also help you to get mobile again as soon as possible. We advise early mobilization as this also helps reduce your risk of skin damage and thrombosis. Exercises to strengthen your abdominal muscles You can start these as soon as you are feeling more comfortable. Try to do them at least once each day. Pelvic Floor Exercises : You can start doing pelvic floor exercises as soon as you feel comfortable enough and since pregnancy weakens the pelvic floor muscles they are important no matter how you gave birth. 4
Deep stomach exercise: In any comfortable position gently pull in the lower part of your stomach below your belly button making sure your back remains still and breathing normally. Hold your tummy in for ten seconds, then gently let go and repeat five to ten times. You can gradually increase the hold time and as you improve pull in your pelvic floor muscles at the same time. Pelvic Tilt: In a lying position with your knees bent and feet flat on the floor, draw in your abdomen and tilt your pelvis so that the small of your back flattens onto the floor. Hold for up to ten seconds and release gently. Repeat five to ten times. This exercise can also help ease wind and lower back pain. If you feel you need extra support regarding exercises following CS or have concerns about your abdominal muscle tone, ask your doctor or midwife to refer you to the physiotherapy department for advice. If you feel unwell in the first few weeks following your CS or if your wound or the skin around the scar looks red or inflamed, you may have an infection, so tell your midwife or doctor as soon as possible, especially if you feel feverish or have a high temperature. 5
Comfortable positions for feeding your baby after your CS You might like to try holding your baby in a position where there is no weight resting on your CS wound or using a cushion or pillow to support the baby. 6
When you are home again Once you are home you should give yourself time to recover and this may mean you need extra help at home to start with. Do ask for help especially with household jobs that involve bending or stretching. You should not lift anything heavier than you baby for the first six weeks (and that includes your toddler if you have one!) and don t do any heavy lifting or strenuous exercise for the first couple of months after your CS. Three weeks after your CS and onwards : Most women feel much more comfortable and the wound will be healing and less sore but it is important to make sure you build up gradually to normal activity and don t overdo things. In the early weeks going for a short walk, perhaps starting with five minutes and gradually increasing it as you feel comfortable, is a good way to start, and you can increase your level of activity as you feel ready. After about six weeks, if your wound is well healed and vaginal bleeding has stopped, you could do some gentle swimming. You should only plan go back to more active exercise such as jogging, running, cycling or aerobics after about three to four months. The area around your CS scar may feel numb for several months after the CS and this is normal and should gradually improve in time. If you have any concerns about your recovery, please speak to your doctor or midwife. Driving You may not be able to drive for the first six weeks after your CS and you should not plan to do so until you feel comfortable enough to do an emergency stop if you need to. How soon you can start driving again is also dependant on your car insurance company s policy on driving following CS. It is best to contact them to ask for advice and to make sure you will be insured when you drive. 7
Further Information NHS Choices Website www.nhs.uk National Institute for Health & Clinical Excellence www.nice.org.uk Contact details: St Richard s Hospital, Spitalfield Lane, Chichester, West Sussex, PO19 6SE Labour ward: 01243 831433 Antenatal Clinic: 01243 788122 ext. 2871 Worthing Hospital, Lyndhurst Road, Worthing West Sussex, BN11 2DH Labour Ward: 01903 285138 Antenatal Clinic: 01903 205111 ext. 84371 We are committed to making our publications as accessible as possible. If you need this document in an alternative format, for example, large print, Braille or a language other than English, please contact the Communications Office by: email: Communications@wsht.nhs.uk Or by calling 01903 205 111 ext 84038. www.westernsussexhospitals.nhs.uk Department: Women and Children s Maternity Issue date: May 2014 Review date: May 2017 Authors: S Coldwell Maternity Service User, C Bell - Women s Experience Lead, I Dalmeida Physiotherapist 8